| NPI | 1336199710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME32856) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: FL ME0032856) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2026-01-26 |